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Table 2 Effect youth-ACT on severity of psychiatric symptoms

From: The effect of youth assertive community treatment: a systematic PRISMA review

Reference

Main results

Psychiatric disorders in sample (%)

Follow-up (months)

Assessment instruments

Effect sizea & 95% CIb

Adrian & Smith (2014) [46]

Youth-ACT with hospital care and without hospital care was associated with reductions in severity of psychiatric symptoms. Larger effect sizes were found for psychotic symptoms, ASD and mood disorders than for self-harm, eating, and neurotic disorders

Mood:

33

P-Tc

HoNOSCA

Reduction HoNOSCA

Sum-scores

Both groups:

Patients that needed inpatient care during ACT treatment:

Patients with only ACT:

1.2 (1.1, 1.4)

1.2 (0.9, 1.5)

1.3 (1.1, 1.5)

Anxiety:

26

Psychotic:

21

Self-harm:

12

ASD:

2

Eating:

2

Other:

10

Baier et al. (2013) [6]

Youth-ACT is associated with reduction of psychiatric symptoms

Psychotic:

51

P-Tc

HoNOSCA

Reduction HoNOSCA

Sum-scores:

Disruptive behaviour:

Hyperactivity:

Self-injury:

Substance abuse:

Hallucinations:

Non-organic:

Emotional:

1.3 (0.8, 1.8)

0.1 (−0.4, 0.5)

0.3 (−0,1, 0.8)

0.7 (0.2, 1.1)

0.2 (−0.2, 0.6)

1.0 (0.5, 1.4)

0.2 (−0.3, 0.7)

0.8 (0.3, 1.3)

Schizophrenia:

23

Mood:

14

Anxiety:

9

Conduct:

26

Godley et al. (2002) [49]

Preliminary outcomes of Godley et al. (2006) [50]. Significantly more abstinent from marijuana in youth-ACT + Usual Continuing Care (UCC) group compared to only UCC

Substance:

100

3

GAIN

TLFB

Urine tests

Breath-analyser

Interviews

Alcohol use:

Abstinence at follow-up:

Marijuana, 3 months:

0.1 (−0.2, 0.4)

0.4 (0.1, 0.8)

Godley et al. (2006) [50]

Significantly more long-term abstinent from marijuana in youth-ACT + Usual Continuing Care (UCC) compared to only UCC

Substance:

100

3, 6, 9

GAIN

TLFB

Urine tests

Breath-analyser

Interviews

Abstinence at follow-up:

Alcohol, 3 and 9 months:

Marijuana, 3 and 9 months both:

Other drugs, 3 months:

9 months:

0.1 (−0.2, 0.4)

0.3 (0.0, 0.6)

0.2 (−0.1, 0.5)

0.1 (−0.1, 0.3)

Mood:

38

Anxiety:

38

PTSD:

36

ADHD:

57

Conduct:

67

Godley et al. (2010) [51]

Youth-ACT had no additional effect on substance disorders compared to outpatient treatment only

Alcohol:

49

3, 6, 9, 12

GAIN substance problem scale

Urine tests

Additional effect of youth-ACT in symptom reducing

0.1 (−0.2, 0.4)

Marijuana:

75

Mood:

28

Anxiety:

8

PTSD:

19

ADHD:

34

Conduct:

42

Godley et al. (2015) [52]

Significantly more long-term abstinent from marijuana and alcohol in youth-ACT compared to only Usual Continuing Care (UCC)

Alcohol:

58

3, 6, 9, 12

GAIN substance problem scale

Urine tests

Breathalyzer

Abstinence at follow-up:

Alcohol: 12 months:

Marijuana: 12 months:

Other drug: 12 months:

0.3 (0.1, 0.8)

0.3 (0.0, 0.6)

0.3 (0.0, 0.6)

Marijuana:

91

Mood:

32

Anxiety:

46

PTSD:

33

ADHD:

49

Conduct:

65

McFarlane et al. (2014) [40]

Youth-ACT was superior in reducing positive, negative, disorganized symptoms and general symptoms in adolescents compared to community care

Substance:

8

6, 12, 24

SIPS

SCID-I/CV

Symptom reduction:

Positive symptoms:

Negative symptoms:

Disorganized:

0.6 (0.4, 0.9)

0.3 (0.0, 0.5)

0.4 (0.2, 0.7)

Mood:

42

Anxiety:

8

PTSD:

8

OCD:

7

Psychosis:

13

McGarvey et al. (2014) [41]

Youth-ACT reduces marijuana use but does not reduce alcohol use

Substance or co-occurring disorder:

NRd

3, 6, 12

GAIN

Drug tests

Reduction in days marijuana use at follow-up:

Boys at 3 months:

6 months:

12 months:

Girls at 3 months:

6 month:

12 months:

Alcohol use:

Boys at 3 months:

12 months:

Girls at 3 months:

12 months:

0.6 (0.3, 0.9)

0.7 (0.5, 1.0)

0.6 (0.3, 0.8)

0.4 (0.1, 0.8)

0.7 (0.0, 1.1)

0.6 (0.1, 1.1)

0.2 (0.0, 0.5)

0.2 (0.0, 0.5)

0.1 (−0.4, 0.7)

0.1 (−0.4, 0.6)

Schley et al. (2008) [42]

Pre-treatment compared to post-treatment showed significant reduction in suicidality and deliberate self-harm behaviour

Substance:

31

P-Tc

Structured audit questionnaire

developed by youth-ACT team

Suicidality:

Deliberate self-harm:

2.1 (1.4, 2.8)

2.5 (1.7, 3.3)

Mood:

40

Anxiety

22

Psychotic:

9

ADHD/Disrupt.:

38

Eating:

9

Other:

18

Urben et al. (2015) [8]

Reduction in severity of psychiatric symptoms (pre-treatment compared to post-treatment)

Internalizing:

36

P-Tc

HoNOSCA

Reduction in HoNOSCA-scores:

Externalizing scale:

Emotional scale

0.3 (−0.1, 0.5)

0.6 (−0.3, 0.8)

Externalizing:

27

Mix:

37

Urben et al. (2016) [43]

Reduction in severity of psychiatric

Symptoms.

Mood:

30

3, 6, 9

HoNOSCA

Reduction in HoNOSCA

Sum-scores:

Emotional scale:

0.6 (0.0, 1.2)

0.6 (0.0, 1.2)

Anxiety:

19

Conduct disorder:

17

Psychosis:

11

Personality disorder:

4

  1. a Effect sizes were computed as Cohen’s d rounded to the first decimal place. Positive effect sizes represents improvement. Small (≥ 0.2–0.5); medium (> 0.5–0.8); large (> 0.8) [44]
  2. b CI = Confidence interval
  3. c P-T = Pre-Post measurement was conducted
  4. d NR = Not reported